﻿<%@ Page Title="" Language="vb" AutoEventWireup="false" MasterPageFile="~/Site.Master" CodeBehind="addClaim.aspx.vb" Inherits="OAR.addClaim" %>
<asp:Content ID="Content1" ContentPlaceHolderID="HeadContent" runat="server">
    <style type="text/css">
        .auto-style1 {
            color: #CC3300;
        }
    </style>
</asp:Content>
<asp:Content ID="Content2" ContentPlaceHolderID="FeaturedContent" runat="server">
</asp:Content>
<asp:Content ID="Content3" ContentPlaceHolderID="MainContent" runat="server">
    <p>
        <strong>2. WORKER</strong></p>
    <p>
        Full Name&nbsp;
        <asp:TextBox ID="tb_workerName" runat="server" Width="291px"></asp:TextBox>
&nbsp;&nbsp;&nbsp; Gender (M/F)&nbsp;
        <asp:TextBox ID="tb_workerGender" runat="server" MaxLength="1" ToolTip="Please enter M or F"></asp:TextBox>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span class="auto-style1"><strong>NRC</strong></span>&nbsp;&nbsp;&nbsp;
        <asp:TextBox ID="tb_workerNRC" runat="server"></asp:TextBox>
    </p>
    <p>
        Occupation
        <asp:TextBox ID="tb_workerOccupation" runat="server" Width="286px"></asp:TextBox>
&nbsp;&nbsp;&nbsp;&nbsp; Date of Birth&nbsp;
        <asp:TextBox ID="tb_workerDOB" runat="server" CausesValidation="True" ToolTip="Please enter date in DD/MM/YYYY format"></asp:TextBox>
    </p>
    <p>
        Village&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
        <asp:TextBox ID="tb_workerVillage" runat="server" Width="280px"></asp:TextBox>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Chief&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
        <asp:TextBox ID="tb_workerChief" runat="server"></asp:TextBox>
    </p>
    <p>
        District&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
        <asp:TextBox ID="tb_workerDistrict" runat="server" Width="274px"></asp:TextBox>
    </p>
    <p>
        Residential Address&nbsp;
        <asp:TextBox ID="tb_workerAddress" runat="server" Width="708px"></asp:TextBox>
    </p>
    <p>
        Email Address&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
        <asp:TextBox ID="tb_workerEmail" runat="server" Width="211px"></asp:TextBox>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Tel/Cell&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
        <asp:TextBox ID="tb_workerTelNbr" runat="server" Width="360px"></asp:TextBox>
&nbsp;</p>
    <p>
        Marital Status (S/M)&nbsp;&nbsp;&nbsp;
        <asp:TextBox ID="tb_workerMaritalStatus" runat="server" Width="54px" MaxLength="1" ToolTip="Please enter S or M"></asp:TextBox>
&nbsp;&nbsp;
    </p>
    <p>
        Name of Spouse&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
        <asp:TextBox ID="tb_workerSpouseName" runat="server" Width="212px"></asp:TextBox>
&nbsp;&nbsp;&nbsp; Spouse Date of Birth&nbsp;&nbsp;&nbsp;
        <asp:TextBox ID="tb_workerSpouseDOB" runat="server"></asp:TextBox>
    </p>
    <p>
        Is worker right or left handed (R/L)&nbsp;&nbsp;&nbsp;
        <asp:TextBox ID="tb_workerRLHanded" runat="server" Width="57px" MaxLength="1" ToolTip="Please enter R or L"></asp:TextBox>
    </p>
    <p style="margin-left: 280px">
        <asp:Button ID="bt_saveWorker" runat="server" Text="Save Worker Information" />
    </p>
</asp:Content>
